Commission on Accreditation of Ambulance Services CAAS GVS 2015

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1 Commission on Accreditation of Ambulance Services CAAS GVS 2015

2 ABBREVIATIONS, TERMS & ACRONYMS USED IN THIS DOCUMENT AAA American Ambulance Association GXL Thin wall automotive wire AAMS AC ACEP AD AMD AMECA ANSI ASMI ASTM Association of Air Medical Services Alternating current American College of Emergency Physicians Additional duty Ambulance Manufacturers Division Automotive Manufacturers Equipment Compliance Agency American National Standards Institute Association and Society Management International American Society For Testing And Materials HHS IAFC ILAC KKK-A MIL MRA NACLA NAEMSP NAEMT U.S. Department of Health & Human Services International Association of Fire Chiefs International Laboratory Accreditation Cooperation Federal Specification for the Star-of- Life Ambulance Military Mutual Recognition Arrangement National Cooperation for Laboratory Accreditation National Association of EMS Physicians National Association of EMTs AVSC CAAS Automatic vehicle stability control Commission on the Accreditation of Ambulance Services NASEMSO NEC National Association of State EMS Officials National Electrical Code CARB Center for Advanced Research in Biotechnology NEMA National Electrical Manufacturers Association CFR CG DC DHS DOT EMSC EMSP EPA EPDM FCC FMCSR FMVSS FSAM GAWR GSA GVS GVWR Code of Federal Regulations Center of gravity Direct current U.S. Department of Homeland Security U.S. Department of Transportation Emergency Medical Services For Children Program Emergency medical service provider U.S. Environmental Protection Agency Ethylene propylene terpolymer rubber Federal Communications Commission Federal Motor Carrier Safety Regulations Federal Motor Vehicle Safety Standards Final stage ambulance manufacturer Gross axle weight rating U.S. General Services Administration Ground Vehicle Standard Gross vehicle weight rating NEMSMA NFPA NHTSA NIOSH NIST NTEA NVFC OEM OSHA RF RPM SAE SXL USP National EMS Management Association National Fire Protection Association National Highway Traffic Safety Administration National Institute for Occupational Safety & Health National Institute of Standards and Technology National Truck Equipment Association National Volunteer Fire Council Original Equipment Manufacturer Occupational Safety and Health Administration Radio frequency Revolutions per minute Society Of Automotive Engineers Standard wall automotive wire United States Pharmacopeial Convention Commission on Accreditation of Ambulance Services

3 TABLE OF CONTENTS SECTION A - SCOPE, PURPOSE, CLASSIFICATION AND DEFINITIONS 3 SECTION B - APPLICABLE DOCUMENTS 5 SECTION C - REQUIREMENTS 8 C.1 GENERAL VEHICULAR DESIGN, TYPES, AND CONFIGURATION 8 C.2 VEHICLE, AMBULANCE COMPONENTS, EQUIPMENT, AND ACCESSORIES 8 C.3 RECOVERED MATERIALS 8 C.4 VEHICLE OPERATION, PERFORMANCE, AND PHYSICAL CHARACTERISTICS 9 C.5 VEHICLE WEIGHT RATINGS AND PAYLOAD 10 C.6 CHASSIS, POWER UNIT, AND COMPONENTS 12 C.7 ELECTRICAL SYSTEM AND COMPONENTS 14 C.8 LIGHTING, EXTERIOR AND INTERIOR 21 C.9 CAB-BODY DRIVER COMPARTMENT AND EQUIPMENT 25 C.10 AMBULANCE BODY AND PATIENT AREA 27 C.11 STORAGE COMPARTMENTS 31 C.12 OXYGEN, MAIN SUPPLY AND INSTALLATION AND SUCTION 33 C.13 ENVIRONMENTAL: CLIMATIC AND NOISE PARAMETERS 34 C.14 COMMUNICATIONS 35 C.15 ADDITIONAL SYSTEMS, EQUIPMENT, ACCESSORIES, AND SUPPLIES 36 C.16 PAINTING, COLOR, AND MARKINGS 36 C.17 MARKINGS, AND CAUTION AND IDENTIFICATION PLATES 37 C.18 MANUALS AND HANDBOOK OF INSTRUCTION 37 C.19 WORKMANSHIP STANDARD 37 SECTION D - CAAS GVS COMPLIANCE CERTIFICATION REQUIREMENTS 39 D.1 QUALIFYING PROVISIONS 39 D.2 DOCUMENTATION OF CAAS GVS 2015 COMPLIANCE CERTIFICATION 39 D.3 CRITERIA OF CERTIFICATIONS 39 D.4 CERTIFICATION LETTER FORMAT 40 D.5 CERTIFICATION VERIFICATION DATA REPORTS 40 D.6 TESTS 40 SECTION E - CHANGES AND AMENDMENTS 41 E.1 CHANGES AND AMENDMENTS 41 E.2 GENERAL INQUIRIES REQUEST FOR INTERPRETATION 41 E.3 PROCESS FOR REVISION 41 APPENDIX 1 - FIGURES 42 APPENDIX 2 - BUYERS GUIDE 47 Commission on Accreditation of Ambulance Services

4 SECTION A - SCOPE, PURPOSE, CLASSIFICATION AND DEFINITIONS A.1 SCOPE This Standard identifies the minimum requirements for new automotive Emergency Medical Services (EMS) ground ambulances built on Original Equipment Manufacturer's Chassis (OEM) that are prepared by the OEM for use as an ambulance. This Standard applies to new vehicles only. The Standards referenced in GVS 2015 do not apply to the following vehicle categories: 1. Military Vehicles/Combat Support Ambulances 2. Wheel Chair Vans/Transport Vehicles 3. Mass-Casualty Vehicles/Ambulance Buses 4. Refurbished or Remounted Ambulance 5. Fire Apparatus APPENDIX 2 of this standard contains: 1. Optional configurations. 2. A worksheet to assist the purchaser in developing their procurement requirements. A.2 PURPOSE The object of CAAS, this document, an ambulance standard is to best serve patients by providing ground ambulances that are safe, nationally recognized, properly constructed, easily maintained, and, when professionally staffed and provisioned, will function reliably in pre-hospital or other mobile emergency medical service. The purpose of this document is to identify the standards for ground ambulances that are authorized to display the CAAS GVS symbol. It establishes minimum requirements, performance parameters and essential criteria for the design of ground ambulances in an effort to provide a practical degree of standardization. A.3 CAAS GVS CERTIFICATION The final stage ambulance manufacturer (FSAM) shall furnish to a purchaser an authenticated certification and label stating that the ambulance and equipment comply with the current standard in effect on the date the ambulance is contracted for. FSAMs making this certification are permitted to use the CAAS GVS symbol to identify an ambulance as compliant with the CAAS standards for ambulances. Use of the symbol must be in accordance with the purpose and use criteria set forth in these published guidelines by the Commission on Accreditation of Ambulance Services. A.4 DEFINITIONS A.4.1 DEFINITION OF GROUND AMBULANCE The ambulance is defined as a vehicle used for emergency medical care that consists of: 1. A driver s cab compartment. 2. A patient compartment to accommodate an emergency medical services provider (EMSP) and a minimum of one patient located on the primary cot so positioned that the patient(s) can receive appropriate medical care during transit. 3. Equipment and supplies for emergency care at the scene as well as during transport. 4. Safety, comfort, and avoidance of aggravation of the patient s injury or illness. 5. Two-way radio communication. 6. Audible and Visual Traffic warning devices. 4

5 (NOTE: Stretcher Vans are not included in this definition) A.4.2 A.4.3 DEFINITION OF ADDITIONAL CONSIDERATIONS Additional Considerations located throughout this document. These boxes contain recommendations that currently exceed or enhance the existing standard to address specific needs or future innovations at the individual purchaser preference. Some local and state requirements may supersede these requirements. RECOVERED MATERIALS The term recovered materials means materials that have been collected or recovered from solid waste and reprocessed to become a source of raw materials, as opposed to virgin raw materials. 5

6 SECTION B - APPLICABLE DOCUMENTS B.1 THE FOLLOWING STANDARDS AND REGULATIONS FORM A PART OF THIS STANDARD, TO THE EXTENT SPECIFIED OR REQUIRED BY LAW. UNLESS A SPECIFIC ISSUE OF A STANDARD OR REGULATION IS IDENTIFIED, THE ISSUE IN EFFECT, ON THE DATE THE AMBULANCE IS CONTRACTED FOR, SHALL APPLY. Military Standards: MIL-STD-461 Requirements for the Control of Electromagnetic Interference Characteristics of Subsystems and Equipment. LAWS AND REGULATIONS: 29 CFR Definition and Requirements for a Nationally Recognized Testing Laboratory 40 CFR 86 Control of Air Pollution from New Motor Vehicles and New Motor Vehicle Engines 47 CFR, PART 90 Public Safety Radio Services (FCC) 49 CFR 571 Federal Motor Vehicle Safety Standards (FMVSS) 29 CFR Occupational Noise Exposure ISO STANDARDS: ISO/IEC General requirements for the competence of testing and calibration laboratories National Truck Equipment Association / Ambulance Manufacturers Division (AMD): AMD Standard 001 Ambulance Body Structure Static Load Test AMD Standard 002 Body Door Retention Components Test AMD Standard 003 Oxygen Tank Retention System AMD Standard 004 Litter Retention System AMD Standard volt DC Electrical System Test AMD Standard 006 Patient Compartment Sound Level Test AMD Standard 007 Patient Compartment Carbon Monoxide Level Test AMD Standard 008 Patient Compartment Grab Rail Static Load Test AMD Standard v AC Electrical Systems Test AMD Standard 010 Water Spray Test AMD Standard 011 Equipment Temperature Test AMD Standard 012 Interior Climate Control Test AMD Standard 013 Weight Distribution Guidelines AMD Standard 014 Engine Cooling System Test AMD Standard 015 Ambulance Main Oxygen System Test AMD Standard 016 Patient Compartment Lighting Level Test AMD Standard 017 Road Test AMD Standard 018 Rear Step and Bumper Static Load Test AMD Standard 019 Measuring Guidelines: Cabinets & Compartments AMD Standard 020 Floor Distributed Load Test AMD Standard 021 Aspirator System Test, Primary Patient AMD Standard 022 Cold Engine Start Test AMD Standard 023 Siren Performance Test 6

7 AMD Standard 024 AMD Standard 025 Perimeter Illumination Test Measuring Guidelines: Occupant Head Clearance Zones Society Of Automotive Engineers (SAE), Inc., Standards, And Recommended Practices: J163 Low Tension Wiring and Cable Terminals and Splice Clips J551 Performance Level of Electromagnetic J553 Circuit Breakers J561 Electrical Terminals, Eyelet, and Spade Type J575 Tests for Motor Vehicle Lighting Devices & Components J576 Plastic Materials, For Use In Optical Parts Such As Lenses and Reflectors of Motor Vehicle Lighting Devices J578 Color Specification for Electric Signal Lighting Devices J683 Tire Chain Clearance J845 Optical Warning Devices for Authorized Emergency, Maintenance, and Services Vehicles J928 Electrical Terminals, Pin, and Receptacle Type J2498 Minimum Performance of the Warning Light System Used on Emergency Vehicles J3026 Ambulance Patient Compartment Seating Integrity and Occupant Restraint J3027 Ambulance Litter Integrity, Retention, and Patient Restraint J3043 Ambulance Equipment Mount Device or Systems National Fire Protection Association (NFPA) 1901 Standard for Automotive Fire Apparatus 70 National Electric Code American Society For Testing And Materials (ASTM) Standards: B117 Standard Practice for Operating Salt Spray (Fog) Apparatus IPC-610D Acceptability of Electronic Assemblies B.2 OTHER PUBLICATIONS The following documents are useful references. Unless a specific issue is identified, the issue in effect, on the date the ambulance is contracted for, shall apply. Federal Standards: RR-C-901C Standard No. 297 MIL-STD-1223 Cylinders, Compressed Gas: High Pressure, Steel Dot 3aa And Aluminum Applications Rustproofing of Commercial (Non-tactical) Vehicles Non-tactical Wheeled Vehicles, Painting, Identification Marking, and Data Plate Standards. 29 CFR Blood borne Pathogens 21 CFR 820 Quality System Regulation Society Of Automotive Engineers, Inc., Standards, And Recommended Practices: J537 Storage Batteries J541 Voltage Drop for Starting Motor Circuits J595 Flashing Warning Lamps for Authorized Emergency, Maintenance, and Service Vehicles 7

8 J638 J639 J682 J858 J994 J1054 J1127 J1128 J1292 J1349 J1318 Test Procedure and Ratings for Hot Water Heaters for Motor Vehicles Safety Practices for Mechanical Vapor Compression Refrigeration Equipment or Systems Used To Cool Passenger Compartment of Motor Vehicles Rear Wheel Splash and Stone Throw Protection Electrical Terminals, Blade Type Backup Alarms, Performance Test and Application Warning Lamp, Alternating Flashers Battery Cable Low Tension Primary Cable Automobile, Truck, Truck-Tractor, Trailer, and Motor Coach Wiring Engine Power Test Code, Spark Ignition and Diesel Strobe Warning Lights American College Of Emergency Physicians (ACEP): Guidelines for Ambulance Equipment American Society For Testing And Materials Standards: F 920 Standard Specification for Minimum Performance and Safety Requirements for Resuscitators Intended for Use with Humans F 960 Standard Specification for Medical and Surgical Suction and Drainage Systems D 4956 Standard Specification for Retroreflective Sheeting for Traffic Control D6210 Standard Specification for Fully-Formulated Glycol Base Engine Coolant for Heavy-Duty Engines National Emergency Medical Services For Children (EMSC) National Resource Center (NRC): Committee On Ambulance Equipment And Supplies Guidelines for Pediatric Equipment and Supplies for Basic and Advanced Life Support Ambulances Automotive Manufacturers Equipment Compliance Agency (AMECA): Approval of Motor Vehicle Safety Equipment (emergency lights and sirens) American National Standards Institute (ANSI): Z535.1 American National Standard for Safety Colors B.3 ORDER OF PRECEDENCE In the event of a conflict between the text of this standard and the references cited, the text of this standard shall take precedence. 8

9 SECTION C - REQUIREMENTS C.1 GENERAL VEHICULAR DESIGN, TYPES, AND CONFIGURATION C.1.1 C.1.2 DESIGN The ambulance and equipment furnished under this standard shall be the OEM s untitled commercial vehicle of the Type and Configuration specified. The ambulance shall be complete with the operating accessories, as specified by the purchaser. The design of the vehicle and the specified equipment shall permit accessibility for servicing, replacement, and adjustment of component parts and accessories with minimum disturbance to other components and systems. The term heavy- duty, as used to describe an item, shall mean in excess of the standard quantity, quality, or capacity and represents the best, most durable, strongest, etc., part, component, system, etc., that is commercially available on the OEM chassis. TYPE I AMBULANCE (10,001 TO 14,000 Gross Vehicle Weight Rating (GVWR)) Type I vehicle shall be a cab chassis furnished with a modular ambulance body. C TYPE I-AD (ADDITIONAL DUTY) AMBULANCE (14,001 GVWR OR MORE) Type I-AD shall be a Cab-Chassis with modular ambulance body, increased GVWR, storage, and payload. C.1.3 C.1.4 TYPE II AMBULANCE (8,000 10,000 GVWR) Type II ambulance shall be a chassis, with Integrated cab-body. TYPE III AMBULANCE (10,001 TO 14,000 GVWR) Type III shall be a Cutaway Van with modular ambulance body. C TYPE III-AD AMBULANCE (14,001 GVWR OR MORE) Type III-AD shall be a Cutaway Van with modular body, and increased GVWR, storage, and payload. C.1.5 CONFIGURATION OF PATIENT COMPARTMENT Primary cot shall be loaded to position the patient s head forward in the ambulance. The primary cot shall be mounted to provide maximum access from the EMSP seat. C.2 VEHICLE, AMBULANCE COMPONENTS, EQUIPMENT, AND ACCESSORIES The ambulance s chassis, cab, patient compartment, and accessories supplied by the FSAM, shall be standard commercial products, tested and certified to meet or exceed the requirements of this Standard. The ambulance shall comply with all Federal Motor Vehicle Safety Standards and other applicable Federal and state regulations specified for the year of manufacture. The chassis, components, and optional items shall be as represented in the OEM s current technical data. The ambulance body, equipment, and accessories shall be as represented in their respective FSAM s current technical data. C.3 RECOVERED MATERIALS All equipment, material, and articles required under this standard are to be new or fabricated from new materials produced from recovered materials. None of these materials shall be interpreted to mean that the use of used or rebuilt products is allowed. 9

10 C.4 VEHICLE OPERATION, PERFORMANCE, AND PHYSICAL CHARACTERISTICS All requirements in Section C.4 shall be met with the ambulance loaded at curb weight plus total usable payload. C.4.1 TEMPERATURE CONDITIONS The vehicle shall be capable of operating safely and efficiently, according to AMD Standard 011 (Equipment Temperature Test) and under the following environmental conditions: C EXTERIOR The ambulance shall be tested to operate at a minimum ambient temperature range from 0 F to 95 F. C INTERIOR The interior of the ambulance patient compartment must be maintained at a minimum temperature of 50 F when the ambulance is prepared for immediate response. This requirement does not apply to ambulances that are fully operational but being held in reserve or ambulances that are not fully operational. C.4.2 C.4.3 C.4.4 C.4.5 C.4.6 NOISE AND SOUND LEVEL LIMITS, EXTERIOR Unless more stringent sound levels are regulated by the states and municipalities where the ambulance will be based, the exterior noise level produced by the vehicle, except siren, shall not exceed Federal regulations. VEHICLE PERFORMANCE The ambulance shall provide a smooth, stable ride. When available from the OEM, automatic vehicle stability control (AVSC) shall be furnished. The completed ambulance shall conform to AMD Standard 017 (Road Test). SPEED The vehicles shall be capable of a sustained speed of not less than 65 mph over dry, hard surfaced, level roads, at sea level, and passing speeds of 70 mph when tested under normal ambient conditions. ACCELERATION Vehicle shall have a minimum average acceleration, at sea level, of 0-55 mph within 25 seconds. Test shall be performed under normal ambient conditions and in accordance with AMD Standard 017. GRADEABILITY The vehicle shall be capable of meeting the following performance requirements. The determination shall be made by actual test or OEM s certified computer prediction. C GRADEABILITY AT SPEED Minimum gradeability at speed shall be 55 mph on a 3% (1.72 ) grade. C MINIMUM LOW SPEED GRADEABILITY The minimum low speed gradeability shall be 5 mph on a 35% (19.3 ) grade. 10

11 C.4.7 C.4.8 FORDING The vehicle shall be capable of three fordings, without water entering patient and equipment compartments while being driven through a minimum of 8" of water, at speeds of 5 mph, for a distance of at least 100'. VEHICLE PHYSICAL DIMENSIONAL REQUIREMENTS The ambulance dimensions (length, width, height) must comply with all applicable local, state and Federal regulations. Length, width, and height are defined by, and should be documented in the purchasing agreement: LENGTH Overall length of the ambulance (OAL) specified shall include bumpers, rear step and bumper guards. WIDTH The overall width of ambulance bodies shall exclude mirrors, lights, and other safety appurtenances. HEIGHT Overall height shall be when loaded to curb weight. This should include roof-mounted equipment, but excludes two-way radio antenna(s). C ANGLE OF APPROACH, RAMP BREAKOVER AND DEPARTURE With the exception of the OEM s furnished and installed components, the ambulance shall provide not less than the following clearance: Approach angle 20 Ramp breakover 10 Departure angle 10 C TURNING RADIUS Turning radius shall not be greater than the OEM standard. C FLOOR HEIGHT The finished floor height shall be a maximum of 34 in order to facilitate manual and/or power cot loading. C.5 VEHICLE WEIGHT RATINGS AND PAYLOAD C.5.1 C.5.2 CURB WEIGHT Non-permanently mounted equipment is considered to be part of the payload, not the curb weight. PAYLOAD CAPACITY The ambulance shall not be operated in an overloaded condition. EMSPs should determine that the actual load, to be placed on the vehicle, does not exceed the total usable payload as manufactured. Any additional items attached to, or carried on the vehicle by the EMSP will reduce the combined weight of occupants and Cargo/Equipment that comprise the total usable payload. Additional weight added, resulting from specified options, will reduce the available payload per vehicle. Occupant weight shall be accommodated at 171 lbs. for each designated patient and seating position. 11

12 The required minimum payload (patients, passengers and cargo/equipment) per vehicle with optional permanently mounted equipment shall be 1,300 lbs. Each ambulance s payload capacity shall be determined by completing a National Truck Equipment Association (NTEA) UltraMod spreadsheet (available at A copy of the spreadsheet shall be included in the handbook of instructions. The following shall be shown on the spreadsheet: 1. Completed vehicle at curb weight pounds at the horizontal center of each patient location and at each seated position 3. The maximum remaining Cargo/Equipment capacity located at the horizontal center of the patient compartment that does not result in weights that exceed the vehicle s GVWR, front or rear GAWR The total usable cargo/equipment capacity value of Figure 2, item 10 shall be displayed on the certification and payload signage as shown in Figure 1. The label shall be located in a conspicuous location in the ambulance. C.5.3 C.5.4 GROSS VEHICLE WEIGHT RATING The combination of the vehicle s curb weight and total usable payload weight shall not exceed the ambulance GVWR. WEIGHT DISTRIBUTION Purchasers and FSAMs shall locate vehicle-mounted components, equipment, and supplies to provide a vehicle that is laterally balanced and within the GVWR and each gross axle weight rating. The right and left wheel(s) of each axle of a completed ambulance shall be weighed to determine horizontal and lateral weight distribution. The weight distribution of a properly loaded ambulance on a level surface shall permit conformance to the FMVSS 105 braking requirements in accordance with the statements provided by the OEM. The ambulance shall conform to AMD Standard 013 (Weight Distribution Guidelines). All specifications and requirements for weight distribution and center of gravity of the OEM, where the OEM s requirements are more restrictive or comprehensive, shall take precedence over the requirements contained in this section. 1. The weight between the right and left side of a given axle, when on a level surface, shall be within 5%. 2. When loaded to the GVWR and within the GAWR for each axle, the front to rear weight distribution shall have not less than 20% of the total weight on the front axle, and not less than 50% nor more than 80% on the rear axle. 3. The FSAM shall locate the center of gravity (CG) of the vehicle according to the requirements set by the OEM to determine and assure that the CG of the completed ambulance does not exceed any maximum horizontal and/or vertical limits. To meet the above weight distribution requirements, consideration shall be given by the purchaser and FSAM to locate equipment and components to permit inherently proper lateral balance, front/rear axle loading, and center of gravity position. C.5.5 RATINGS Vehicle and component ratings shall be the OEM s published ratings and shall not be raised above the OEM s rating. 12

13 C.5.6 CAB TO AXLE (CA), TYPE I AND III VEHICLES. Cab to axle (CA) dimension of the vehicle chassis shall permit a minimum of 50% of the outside body length (including cab extensions) forward of the rear axle centerline, in addition to any cab to body clearance. Bodies designed with wheel openings shall have the rear wheels centered, within +/- 2" of those openings. C.6 CHASSIS, POWER UNIT, AND COMPONENTS C.6.1 C.6.2 C.6.3 CHASSIS-FRAME The chassis shall include the OEM s ambulance preparation package when available. The chassis-frame and components shall be constructed to withstand the strains of on-off road service and any special service and equipment requirements specified. All chassis (including cab) components shall be as represented in the OEM s technical data. VEHICLE LUBRICATION The chassis components, devices, accessories, and added equipment requiring lubrication shall be fully equipped with lubrication fittings, as provided by the OEM or equipment manufacturer. POWER UNIT, ENGINE C POWER UNIT The power unit shall meet or exceed the required vehicle performance specified at not more than the engine manufacturer s recommended operating engine speed. The OEM s diesel or gas engine and power train shall be provided. C ENGINE LOW TEMPERATURE STARTING The engine shall start satisfactorily without the aid of engine block preheating devices (except glow plugs) or combustion air preheater at 0 F. The determination shall be made by actual test conforming to AMD Standard 022 (Cold Engine Start Test) or OEM s certification. C.6.4 POWER UNIT COMPONENTS C OIL FILTER The oil filter shall be the OEM s standard for the engine offered. C AIR FILTER The air filter shall be the OEM s standard for the engine offered. C AIR POLLUTION CONTROL The vehicle and engine shall conform to 40 CFR Subchapter C-Part 86 - Control of Emissions from New and In-use Highway Vehicles and Engines", as evidenced by an EPA certificate of compliance. Vehicles shall also comply with all pollution control requirements for the state of final destination. Certificates of compliance shall be made available upon request. C FUEL SYSTEM The fuel system shall conform to all applicable FMVSS, Federal Motor Carrier Safety Regulations (FMCSR), Center for Advanced Research in Biotechnology (CARB), and Environmental Protection Agency (EPA) requirements. The fuel system components shall be installed, connected, and 13

14 routed in accordance with all OEM s guidelines. A permanent label at the fuel filler opening shall be furnished specifying the specific type of fuel required. C COOLING SYSTEM A coolant overflow recovery tank and compensating system shall be furnished. The cooling system shall be protected with an OEM solution of extended life antifreeze/coolant. Coolant to be the OEM s recommended type and mixture. The FSAM shall provide the OEM maximum size cooling system for the engine provided. The cooling system design shall maintain the engine at safe operating temperatures at all drivable altitudes and grades encountered during on and off road vehicle use. The engine cooling system shall conform to AMD Standard 014 (Engine Cooling System Test). C EXHAUST SYSTEM The exhaust shall discharge at the vertical side(s) of the ambulance at a maximum distance of 1" beyond the side of the module and be angled /positioned to project the exhaust away from the door(s) to minimize fumes and contaminants entering the interior. On modular vehicles, the tailpipe outlet shall not terminate within 12" of the vertical axis of the fuel tank filler opening(s) when located on the same side. Modifications or extensions made to the OEM exhaust system shall meet or exceed OEM s requirements in terms of backpressure, components, design, and workmanship. C.6.5 DRIVE TRAIN C DRIVE TRAIN COMPONENTS The drive train and component s torque capacity shall meet or exceed the maximum torque developed in the lowest gear ratio by the engine. C AUTOMATIC TRANSMISSION The OEM s automatic transmission shall be provided. The transmission shall provide not less than four speeds forward and one reverse and shall be equipped with the OEM s heaviest duty transmission fluid cooler. C DRIVELINE The driveline (driveshaft, U-joints, etc.) shall be balanced and supported to perform throughout the design speed range without whipping or vibrating. C BRAKE SYSTEMS, SERVICE AND PARKING OEM s heaviest duty, power assisted brakes, linings, and parking brake shall be furnished on the OEM chassis offered. Antilock brake systems shall be furnished when available from the OEM. C SPECIAL TRACTION (REAR END) DIFFERENTIAL All ambulances shall have a positive traction, limited slip differential or automatic, locking type differential, unless not furnished with the OEM s AVSC system. C SUSPENSION Vehicle shall be equipped with laterally matched sets (front and rear) of spring, torsion, or air suspension system components. Components shall have a rated capacity in excess of the load imposed on each member. Only corrections permitted by the OEM to compensate for lean due to normal spring tolerance variations are permitted. Correction of lean due to imbalance is not permitted. 14

15 C SPRING STOPS The OEM s standard spring bumpers and axle stops shall be furnished. The stops/bumpers shall prevent the wheel and axles from striking the engine, oil pan, fenders, and body under all conditions of operation. C SHOCK ABSORBERS Shock absorbers, double-acting type, heaviest duty available from OEM for model offered, shall be furnished on the front and rear axles. C.6.6 C.6.7 C.6.8 C.6.9 STEERING The OEM s standard, power assisted steering shall be furnished. WHEELS Types I, II & III ambulances shall be equipped with dual rear wheels and single front wheels. Type II ambulances shall be equipped with single, front and rear wheels. Wheels shall conform to the recommendations of the Tire and Rim Association, Inc., and shall be recommended by the OEM guidelines. TIRE CHAINS AND CLEARANCE Tire chain clearance on the furnished body shall be provided for all driving wheels per SAE J683. Sufficient chain clearance shall be provided to permit off road operation with the ambulance loaded to the maximum payload. WHEEL TIRE BALANCING Wheel/tire, hubs, and brake drum assemblies of the vehicle shall be dynamically balanced to a minimum of 70 mph. C.6.10 WINDSHIELD WIPERS AND WASHERS Vehicle shall be equipped with OEM intermittent windshield wipers. C.6.11 HORNS The OEM s dual electric horns shall be furnished. C.7 ELECTRICAL SYSTEM AND COMPONENTS C.7.1 ELECTRICAL SYSTEM The ambulance electrical system shall be equipped with, but not limited to, the following: 1. Dual, OEM s batteries. 2. Generating, starting, lighting, visual and audible warning systems. 3. Specified electronics equipment and devices (including master consoles located in the cab and patient compartment shall conform to FMVSS 101). 4. Other specified accessory wiring. 5. All electrical system components and wiring shall be readily accessible through access panels. 6. All switches, indicators, and controls shall be located and installed in a manner that facilitates easy removal and servicing. 7. All exterior housings of lamps, switches, electronic devices, connectors, and fixtures shall be corrosion resistant and weatherproofed. 15

16 8. Electrical fixtures attached to the exterior sides of the ambulance below the 75" level shall be near flush mounted and not protrude more than 2", except for such items as spotlights and ventilators. 9. Vehicles shall be immune from interference caused by radio transmissions. C WARNING INDICATORS The electrical system shall incorporate a warning light panel located in the driver s compartment. It shall provide indicator lights for: 1. Any patient compartment or exterior equipment door that is not closed. 2. Any driver s cab compartment and/or doors not closed (when available from the OEM). 3. Extended devices (flood lights, etc). 4. Lights on inside the vehicle. 5. Master battery switch. The Door/Equipment Open indicator in the driver s compartment can be either a warning incandescent light with at least 0.2 sq. in. of lighted surface, an electronic text message visible in all ambient lighting conditions, or LED s with equal intensity as an incandescent light source. Electronic displays that are visible in all ambient light, that projects narrative information may be used in lieu of discrete, colored, indicator/ warning lights provided the projected message is at least as visible as the basic required warning light. C.7.2 WIRING INSTALLATION 1. The ambulance body and accessory electrical equipment shall be served by circuit(s) separate and distinct from vehicle chassis circuits. 2. All wiring provided by the FSAM shall be copper. 3. All wiring shall have type SXL or GXL high temperature cross-linked polyethylene, or better, insulation. 4. The use of multi conductor or ribbon cables are permitted provided they are not exposed to under hood or under vehicle temperatures/conditions. 5. The wiring shall be permanently color-coded or marked the entire length of the wire. 6. Wiring shall be routed in conduit or high temperature looms with a rating of 300 F. 7. When cables are supplied by a component manufacturer to interconnect system components, these cables need not be continuously color coded/identified. They shall be coded/identified at the termination or interconnection points. 8. All added wiring should be located in accessible, enclosed, protected locations and kept at least 6" away from exhaust system components. 9. Electrical wiring and components shall not terminate in the oxygen storage compartment except for the oxygen controlled solenoid, compartment light, and switch plunger or trigger device. 10. Wiring passing through an oxygen compartment shall be protected from damage. 11. All conduits, looms, and wiring shall be secured to the body or frame with insulated cable straps. 12. All apertures on the vehicle shall be properly grommeted for passing wiring. 13. All items used for protecting or securing the wiring shall be appropriate for the specific application and be standard automotive, aircraft, marine, or electronic hardware. 14. Cable ties shall not be used to support harnesses, but may be used for bundling purposes. 15. Electrical panels that are accessible to accidental contact shall have a protective cover, shield, etc. to prevent shorts that can result in injury, fire, or damage to the electrical system. 16. Wiring shall not be secured to brake lines and/or fuel lines. 16

17 C WIRING CRITERIA 1. All wiring (including grounds), devices, switches, outlets, etc., except circuit breakers, shall be rated to carry at least 125% of the maximum ampere load. 2. A service loop of wire or harness shall be provided at all electrical components, terminals, and connection points. 3. All splices and terminals provided shall comply with SAE J163, J561, or J928 as applicable. 4. All terminals shall be permanently numbered or coded. 5. Terminal strip(s) block(s), or multi-pin connector(s) shall be readily accessible for checking and service. 6. All exterior wiring to lights or any other component in wet locations shall utilize sealed connectors or splices. 7. The ambulance electrical system shall incorporate a master circuit breaker panel with circuit breakers or other electronic, non-disposable, current protection devices, in each circuit, which comply with SAE J553 Type I, or Type III (if circuit breaker is readily accessible for resetting by the driver or EMSP). 8. When multiconductor cables/ribbon cables are used for low current (self limiting) circuits, additional fuses/circuit breakers are not required. 9. One extra 15-ampere circuit breaker shall be provided for future use. 10. For high current circuits, where SAE Type I breakers are not commercially produced, protection for these circuits may be provided with other types of circuit breakers. 11. All circuit breakers shall be securely mounted, easily removable, and readily accessible for inspection and service. 12. All electrical and electronic components, switches, connectors, circuit breakers, lamps, and indicators, including the vehicle batteries, shall be marked with an easily read identification code number and/or letter. C PRINTED CIRCUITS Patient compartment controls must meet or demonstrate quality, durability and reliability performances equivalent to those specified in IPC-A-610E, Classification as Class 3 Life support or other critical Assemblies. C.7.3 GROUNDING Dedicated grounds for all appliances, circuits, etc. shall be furnished. The use of appliance mounting screws/hardware shall not be used for grounding purposes unless specifically designed for such use by the appliance manufacturer. C RF GROUNDING If module is isolated from chassis FSAM to provide radio frequency (RF) grounding and minimize potential interference with OEM s computers, the module and chassis cab shall be connected to the chassis frame with a separate dedicated minimum 3/4", braided ground strap with soldered ends that are secured to cleaned metal surfaces on the body and frame with lock washers. To prevent corrosion, both ends of the attached ground strap shall then be sealed with either rust proofing compounds or non-hardening battery terminal sealer. Regular stranded copper wire, while providing a DC ground, does not provide RF grounding and does not meet this requirement. 17

18 C.7.4 LOW VOLTAGE ELECTRICAL SYSTEM The ambulance shall, when available from the OEM, be equipped with standard or optional generating system designed for ambulance applications, and shall be nominally rated at a minimum of 14 volts, with a minimum under hood temperature of 200 F. The generating system shall be capable of supplying at its regulated voltage, the continuous electrical load, which consists of the following electrical equipment and systems: 1. Engine/transmission control system. 2. Headlights (low beam). 3. All FMVSS 108 lights. 4. Windshield wipers (low speed). 5. Cab air conditioning (at coldest setting with highest blower speed). 6. Radio in receiving mode (or equal load, if not equipped). 7. Patient compartment dome lighting (in the high intensity setting). 8. Patient compartment air conditioning (at coldest setting with highest blower speed). 9. Emergency warning lighting system (in the daytime primary mode) amp medical load or equivalent. The generating system components shall be rated by the manufacturer to supply the maximum electrical load, at the regulated, at a 200 F under hood temperature at an engine speed not exceeding the furnished engine manufacturer s high idle setting in order to maintain battery charge at the regulated voltage. The throttle control device shall control the engine s revolutions per minute (RPM) necessary to maintain the heating and air conditioning systems, at full operating capacity, and to maintain the generating system s required output when the vehicle is stationary. The 12-volt electrical system shall incorporate a voltmeter and low voltage-warning device, which is functionally connected as shown in Figure 3. The FSAM shall test each ambulance, in accordance with AMD Standard 005 (12-Volt Electrical System Test), prior to delivery and provide, to the purchaser, a written certification indicating the amount of generating capacity remaining, at the regulated voltage after supplying the total electrical load as manufactured (including the purchaser options). C ENGINE HIGH-IDLE SPEED CONTROL An engine high-idle speed control shall be furnished. The control shall be set to automatically increase the engine speed to the engine manufacturer s recommended setting to sustain the ambulance s total continuous electrical load at the regulated voltage and provide maximum heating/air conditioning output. The device shall operate only when switched to the ON position and the transmission is in PARK or NEUTRAL. The parking brake shall be applied at all times when the engine high-idle speed control is in use. The device shall disengage high-idle operation according to OEM and/or engine manufacturer disablement strategy, or if not specified, when the operator depresses the service brake pedal or the transmission is placed in gear. 18

19 C VOLTMETER AND VOLTAGE MONITOR A voltmeter illuminated for nighttime operation shall be furnished. The electrical system shall be monitored by a system that provides an audible and visual warning in case of the low voltage to persons in the ambulance of an impending electrical system failure caused by the excessive discharge of the batteries. The charge status of the battery shall be determined by direct measurement of the battery voltage. The alarm shall sound if the system voltage at the battery drops below 11.8 V for 12 V electrical systems for more than 120 seconds. C.7.5 BATTERY SYSTEM Two batteries (or additional batteries as required by the OEM) for ambulance use shall be furnished. Batteries shall be located in a ventilated area, sealed off from occupant compartments, and shall be readily accessible for servicing and removal, with the exception of OEM-installed batteries. C AUTOMATIC CHARGER/CONDITIONER An automatic charger/conditioner shall be provided. The charger/conditioner shall: 1. Be connected to the 12-volt DC battery system as shown in Figure Be capable of supplying a minimum of 10 amperes charging current. 3. Be permanently mounted, in the vehicle, in a properly ventilated, accessible location and wired to the 125-volt AC utility power as shown in Figure Monitor the battery state of charge and, as necessary, automatically charge or maintain the batteries without gassing, depleting fluid level, overheating, or overcharging. C PORTABLE EQUIPMENT CHARGING CIRCUIT A circuit shall be furnished (Figure 5) for charging all portable battery powered devices, i.e. suction units, hand lights, defibrillators, portable radios, etc. This circuit shall prevent discharge of chassis batteries by only permitting the charging of portable devices when the vehicle is either running or the automatic charger/conditioner is connected to shore power. Circuit breaker protection shall be provided and shall have a minimum 10 amp capacity. C INTERNAL 12-VOLT DC POWER (REFER TO FIGURE 3) Two automotive Power Point type connectors shall be furnished, in the patient compartment. Each connector shall be rated for 12-volt DC, 20 ampere capacity, and be on a separately protected circuit. This circuit shall provide a means of isolating the medical equipment batteries from any electrical loads that the remainder of the ambulance electrical system may impose. C MASTER MODULE DISCONNECT SWITCH OR DEVICE An illuminated Module Disconnect switch shall control all electrical loads added by the FSAM, or an illuminated switch controlled solenoid as shown in Figure 3. This switch shall be located in the driver s compartment, be legibly marked, illuminated when ON, and rated to carry at least 125% of the circuit s maximum current. The module disconnect switch or device shall be different in feel from other switches, or be physically isolated from them. C VOLT AC UTILITY POWER (REFER TO FIGURE 4) The ambulance shall be furnished with a 2-wire plus ground 125-volt AC wiring system that is separate and distinct from the vehicle s DC wiring system(s). The AC system is to be utilized while the vehicle is stationary for powering maintenance devices, medical equipment and battery chargers. The AC system shall not be utilized for operational ambulance interior lighting, such as dome and cot lights. 19

20 C UTILITY POWER CONNECTOR A 125-volt AC flanged inlet rated for a minimum of 15 amperes conforming to the National Electrical Manufacturers Association s (NEMA) specifications appropriate for the voltage and amperage, with spring loaded cover assembly suitable for wet locations, shall be installed. The connection shall be permanently labeled with the following: THIS CONNECTION IS FOR 125-VOLT AC, 60 Hz, 15-AMPERE SUPPLY WHEN VHICLE IS NOT IN USE. This receptacle shall energize the vehicle s internal AC circuit from an external power source (utility power). The purchaser s stationary utility power circuit supplying the ambulance s 125-volt AC power should incorporate ground fault protection. A proper mating, weatherproof, 15 ampere connector body rated for a minimum of 15 amperes conforming to NEMA specifications appropriate for the voltage and amperage shall also be furnished without cable and tagged specifying the size, type of wire necessary, and the polarity of the future hookup. C ELECTRICAL 125-VOLT AC RECEPTACLES The patient compartment shall be furnished with two (2) 125-volt AC duplex receptacles conforming to NEMA Receptacles shall be near flush installed on vertical surfaces. All interior outlets shall be installed in accordance with Section (Receptacles and Cord Conductors) of the National Electrical Code (NEC). Outlets shall be at least 12 in from any oxygen outlet. An indicator shall be located within each 125-volt AC receptacle as a line monitor indicating a live (hot) circuit. The receptacles shall be labeled with the following: 125-VOLT AC. C VOLT AC SYSTEMS 1. The electrical equipment and material indicated for connection to a wiring system rated 125 volts, nominal, 2-wire with ground shall incorporate a minimum 15 ampere circuit breaker which can be used as a master AC disconnect switch. 2. The AC wiring shall utilize stranded wire, Type SO or Type SEO cord with a WA suffix, rated at 600V and 194ºF, covered with a minimum 300 F flame retardant wire loom, or approved wire in conduit. 3. All products shall be used only in the manner for which they were tested and found suitable. 4. Other sources of AC power shall be wired in full conformity with the requirements of this standard. 5. Grounding shall be in accordance with Section (Portable and Vehicle Mounted Generators) of the National Electrical Code (NEC). 6. All 125-volt AC receptacle outlets of the ambulance shall have ground fault circuit interrupter protection. 7. Where rigid metal conduit or intermediate metal conduit is terminated at an enclosure with a lock nut and bushing connection; two lock nuts shall be provided, one inside and one outside of the enclosure. All cut ends of conduit shall be reamed or otherwise finished to remove rough edges. 8. Boxes are required for all inlets and/or outlets. 9. Non-metallic boxes shall be acceptable only with non-metallic conduit. 10. Boxes shall be mounted in accordance with Article 370 (Outlet, Device, Pull And Junction Boxes, Conduit Bodies And Fittings) of the NEC. 11. No bend shall have a radius of less than five times the cable or conduit diameter, whichever is greater. 12. Tubing, conduit and loom shall be supported with clamps at the outlet boxes, distribution panel boards and splice boxes on appliances. Supports shall be provided every 24". 20

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